"Thus it is said that one who knows the enemy and knows himself will not be endangered in a hundred engagements."
Sun Tzu, The Art of War.

Tuesday, July 25, 2006

Artists Lend Talents to Transforming Military Amputees

By Donna Miles

WASHINGTON, July 25, 2006 – Seeing his artistry on the big screen was a bit of a rush, but former Hollywood sculptor Chuck O'Brien said it's nothing compared to the satisfaction he gets using his art to help transform military amputees. Army Spc. Adam Standfuss, a Minnesota Army National Guardsman wounded in Iraq, looks on as artist Robert Rubino paints a new artificial hand for him at Walter Reed Army Medical Center. Photo by Michael Dukes

"You can't go wrong working with heroes," O'Brien said as he sat side by side with two colleagues in a broom closet of a room at Walter Reed Army Medical Center here. The three artists, from Connecticut-based Alternative Prosthetics Services, travel to Walter Reed several times a month to create artificial body parts that are almost impossible to tell from the real thing.

During one recent session, Army Spc. Adam Standfuss looked on as O'Brien and Robert Rubino worked their magic on silicone molds of his left arm and damaged right hand. The 24-year-old Minnesota Army National Guardsman was wounded in September when a rocket-propelled grenade pierced his Humvee in Baghdad. He lost his left arm just above the elbow and the pinkie and ring finger on his right hand.

Standfuss said his recovery is progressing well. He was strong enough in late November, just two months after being wounded, to welcome his fellow Guardsmen from the 151st Field Artillery Regiment home. Last month he made another milestone, checking out of Walter Reed to receive community-based care closer to home. At first, the stares Standfuss got whenever he went out in public troubled him, but he said he's gotten used to them. "Now it's just a fact of life," he said with a shrug.

Yet he jumped at the chance to return to Walter Reed to have a realistic, custom-designed arm and hand to replace what he'd lost. "Feeling whole again is what I'm looking forward to most," he said as he sat under a hot white light, watching Rubino paint a silicone "sleeve" to slide over his right hand. Rubino described the painstaking process that goes into making a true-to-life prosthesis.

First the artists take initial impressions of servicemembers' remaining limbs and hands and residual parts of amputated limbs, using liquid silicone that dries in about five minutes and takes on the appearance of cake frosting. Next comes the most time-intensive part of the project, sculpting wax replicas of the missing limbs. From that, the artists create a mold, then coat the inside of it with a thin layer of silicone to create a new silicone skin.

Once they're satisfied with the product, they begin painting, applying multiple layers of paint to the inside of the silicone so it won't wash or rub off. Standfuss stretched his right hand out on a table under bright white lights as Rubino mixed blue, yellow and red paint to match his skin tone. Rubino ignored the suntanned forearms and focused on the undersides and palms, which more closely match Standfuss' year-round skin color.

"Extremities are always changing color due to sun exposure or exertion," Rubino explained. "So we go a little lighter and match the parts that don't suntan." He added slight dabs of pink to his paint canisters for the knuckle and nail areas of the hand and a hint of green where veins would run.

Darker-skinned amputees are a bit more difficult to match, Rubino said. Sometimes he applies real hairs to the inside of the mold to add realism. Other times he adds freckles or moles or touches up tattoos. The result is so realistic that some people do double takes when they walk past the opened door to the workroom. Creating such realism is a long process. "We started at about 10:30 this morning and we'll be at it until about 8 tonight," Rubino said. He estimated that the prosthesis would take 36 hours to produce -- about 12 hours for each of the three artists.

The project gives plenty of other amputees at Walter Reed an opportunity to check on the artists' work. "A lot of people are interested and ask questions about what we're doing," Rubino said. Among them was Ed Salau, a North Carolina National Guardsman who lost his left leg when an RPG penetrated the hull of his Bradley Fighting Vehicle during an ambush in Tikrit, Iraq.

Like many of his fellow amputees at Walter Reed, Salau wears his stump like a badge of honor. "I'm proud of the situation I'm in, and think it's important that it's known," he said.Yet Salau said he looks forward the point where he, too, has healed enough to get a custom-made prosthetic leg at Walter Reed. At Duke University Medical Center, where he receives his care, Salau's doctors had offered to create a Styrofoam likeness of his missing leg and paint it. "I told them to keep it," he said, watching Rubino paint Standfuss' new hand. "This is what I want."

Rubino never imagined he'd spend his career creating prostheses. He originally went to school to study architecture, then became a painter and sculptor. He said he "fell into" the prosthesis business six years ago. He figures he's probably worked with about 100 military amputees since the beginning of the war in Iraq.

O'Brien went to art school to study illustration but knew he "didn't want to design bank brochures for the rest of my life." He went to makeup school in Hollywood and ended up working for a Hollywood effects lab, creating silicon cadavers and body parts for television programs like "CSI: Miami," "The X-Files," and movies, including "Charlie's Angels 2: Full Throttle."

He said two things drove him from the entertainment business: the "nasty chemicals" he worked with too regularly for comfort and the boom in animation he feared would cut his career short. His mother and wife saw a TV program about prosthesis artists and encouraged him toward his new career.

"It's pretty neat to see things you worked on on the big screen, but it's no comparison to what you get out of this," he said as he molded Standfuss' left arm. "This is way more rewarding." "It's an exciting feeling to see the smiles on their faces," Rubino said of the reaction troops have when they see their new prostheses for the first time. "It's nice to see the reaction and know that you did a little something for them."

Sean Curtin, whose brother Michael founded the business, said he wishes everyone at the home office in Fairfield, Conn., could meet the Walter Reed patients they're helping. "It's so gratifying, especially when you see the final product and watch the final fitting," he said. "That's when it really hits home, when you see the patients' reactions and realize what it means to them." "I'm really excited to have something on my arm and to be able to blend in a little better," Standfuss said. He's particularly pleased that he'll look good in photos to be taken at his wedding in August.

But even after being fitted with his new prostheses, Standfuss knows his recovery is far from over. More surgeries await him down the road, not only on his hand, but also on his eardrums and tiny bones in his ears that shattered when the RPG exploded in his Humvee. Standfuss isn't dwelling on that. For now, he said, he's just feeling very lucky -- lucky that he wasn't killed in the RPG attack, that his fellow Guardsmen made it out alive, that he's now able to get medical care closer to home, and that three artists are creating a new lifelike set of prostheses for him. "I feel really fortunate to have them here," he said.

He admits he felt pretty depressed when he first lost his arm and fingers. "Your life is suddenly changed in a split second," he said. "But then you realize that there's always somebody worse off than you. That helps give you perspective." The new prostheses will go a long way toward his recovery. "Being able to blend in a little more is going to be really great," he said. "In some ways, I think this is going to be life-changing."